Nursing responsibilities vary across different oncology infusion centers in the United States. A standard staffing model to provide efficiency of clinical services and patient safety currently does not exist, and the variability of roles can lead to unnecessary costs to the healthcare system. A recent study sought to define the roles of infusion nurses to create efficiencies within the clinical setting, potentially reduce RN staffing requirements, achieve cost savings, and develop a targeted nurse-to-patient ratio that also maintains quality care.

Georgina T. Rodgers, BSN, RN, NE-BC, from the Taussig Cancer Institute at the Cleveland Clinic in Ohio, presented the findings during a poster session at the ONS 41st Annual Congress in San Antonio, TX. The poster was titled “Establishing an Infusion Nurse Staffing Model for Outpatient Oncology Treatment Centers.”

First, Rodgers and colleagues compiled daily patient volume and hours of operation for each outpatient site. They then created a staffing template to predict the number of RNs needed for treatment and analyzed infusion sites to observe workflows. The researchers used an hours-per-unit method using billed charges for technical procedures, and a final target ratio of 1:6 was identified and used.

The pilot site was originally staffed with 14 RN full-time employees, though the analysis indicated that many non-clinical, non-nursing duties were being performed by RNs. After improving roles and functionalities, the site now currently functions with five RN full-time employees.

In summary, Rodgers noted, “The implications of establishing this standard for infusion nursing has allowed us to duplicate the methodology across the health system and achieve a level of staffing that matches well with patient care needs. We have maximized the efficiency of the nursing team, reduced costs, and there has been no decline or compromise in quality or patient safety.”

Rodgers, G.T. (2016). Establishing an infusion nurse staffing model for outpatient oncology treatment centers. Poster presented at the ONS 41st Annual Congress, San Antonio, TX, April 28–May 1, 2016.

Comments

Posted by Elizabeth Chew… (not verified) 12 months ago

This confirms much of what we already know, although it is good to have a study which demonstrates the necessity of honing RN roles in infusion clinics. The task, however, is not simply to define and standardize RN responsibilities to ensure an appropriate RN-patient ratio. It is also to assure that there are fully adequate resources to permit RNs to function safely and effectively according to those ratios, and to undertake ONLY those defined RN responsibilities. While a clinic may set appropriate core staffing levels for RNs, techs/MAs, clinicians, social workers, pastoral and administrative staff, there is rarely a time when all positions are filled, and even then it is usually for only a few moments of blissful relief, and then back to filling the gaps with whatever staff are available...or not. Optimum staffing levels then must account for this, otherwise we will always be functioning at a deficit. And by optimum levels I include administrative staff, and others, who will be assigned and available to deal with the continuous list of outstanding tasks which often land in the RN's lap; missing orders and lab results, contacting late or no-show patients, scanning, ordering, last minute and re-scheduling, dealing with drug reps, calling for environmental services or reporting repairs needed, etc. etc.. If it is decided that some or all of these tasks are in fact RN responsibilities, the RN-patient ratio needs to account for this at the outset. If not established as RN responsibilities, then they should not default back to the RN, because even if intended as a temporary measure, too often this becomes the status quo.

Posted by Jane Burgos (n… (not verified) 12 months ago

My current employer does not have or utilize a staffing grid at our outpatient clinic. I would like supportive data to bring to the regional nursing director to address this issue

Posted by Debbie Hutton … (not verified) 11 months 4 weeks ago

"The researchers used an hours-per-unit method using billed charges for technical procedures, and a final target ratio of 1:6 was identified and used. " Does this 1:6 ratio represent 1 RN administering and monitoring 6 patients at any one time or 6 patients total per shift?

Posted by Georgina Rodge… (not verified) 11 months 4 weeks ago

In reply to by Debbie Hutton … (not verified)

The 1:6 nurse to patient ratio represents a per shift ratio. The RN's typically have 3-4 patients at any one time and the shift ratio ranges between 6-8.

Posted by Katie Moreno (… (not verified) 10 months 3 weeks ago

We are working on something similar at my institution. I would love to see a copy of the poster if possible.

Posted by Azim Gray (not verified) 1 month ago

Do you have a copy of this research?

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